Abstract
Objectives: To examine the regional mortality differences in The Republic of Korea according to geographic location. Methods: All 232 administrative districts of the Republic of Korea in 1998 were studied according to their geographic locations by dividing each district into three categories; "metropolis," "urban," and "rural". Crude mortality rates for doth sexes from total deaths as well as the three major causes of death in Korea (cardiovascular disease, cancer, and external causes) were calculated with raw data from the "1998 report on the causes of death statistics" and resident registration data. Standardized mortality ratios (SMR) were calculated using the indirect standardization method. Poisson regression analyses were performed to examine the effects of geographic locations on the risk of death. To correct for the socioeconomic differences of each region, the percentage of old ($\geq$ 65 years old) population, the number of privately owned cars per 100 population, and per capita manufacturing production industries were included in the model. Results: Most SMRs were the lowest in the metropolis and the highest in the rural areas. These differences were more prominent in men and in deaths from external causes. In deaths from cancer in women, the rural region showed the lowest SMR. In Poisson regression analysis after correcting for regional socioeconomic differences, the risk of death from all causes significantly increased in both urban (OR=1.111) and rural (OR=1.100) regions, except for rural women, compared to the metropolis region. In men, the rural region showed higher risk (OR=1.180) than the urban region (OR=1.l51). For cardiovascular disease and cancer, significant differences were not found between geographic locations, except in urban women for cardiovascular disease (OR=1.151) and in rural women for cancer (OR=0.887), compared to metropolis women. In deaths from external causes, the risk ratios significantly increased in both urban and rural regions and an increasing tendency from the metropolis to the rural region was clearly observed in both sexes. Conclusions: Regional mortality differences according to geographic location exist in The Republic of Korea and further research and policy approaches to reduce these differences are needed. to reduce these differences are needed.